Sexuality after total vs. subtotal hysterectomy
Article first published online: 2 FEB 2004
Acta Obstetricia et Gynecologica Scandinavica
Volume 83, Issue 2, pages 191–196, February 2004
How to Cite
Zobbe, V., Gimbel, H., Andersen, B. M., Filtenborg, T., Jakobsen, K., SØrensen, H. C., Toftager-Larsen, K., Sidenius, K., MØller, N., Madsen, E. M., Vejtorp, M., Clausen, H., Rosgaard, A., Gluud, C., Ottesen, B. S. and Tabor, A. (2004), Sexuality after total vs. subtotal hysterectomy. Acta Obstetricia et Gynecologica Scandinavica, 83: 191–196. doi: 10.1111/j.0001-6349.2004.00311.x
- Issue published online: 2 FEB 2004
- Article first published online: 2 FEB 2004
- Submitted 27 March, 2003Accepted 30 April, 2003
- total abdominal hysterectomy;
- subtotal abdominal hysterectomy;
- sexual function;
- randomized clinical trial;
Background. The effect of hysterectomy on sexuality is not fully elucidated and until recently total and subtotal hysterectomies have only been compared in observational studies.
Aims. To compare total abdominal hysterectomy (TAH) to subtotal abdominal hysterectomy (SAH) regarding effects on sexuality.
Methods. In a Danish multicenter trial 319 women were randomized to TAH (n = 158) or SAH (n = 161); 185 women had self-selected TAH (n = 80) or SAH (n = 105) in a simultaneously conducted observational study. Women were followed for 1 year by strict data collection procedures, including postal questionnaires. Results were analyzed by intention to treat (ITT) analyses.
Results. No significant differences were observed between TAH and SAH at 1-year follow-up in both the randomized trial and the observational study regarding women's desire for sex, frequency of intercourse, frequency of orgasm, quality of orgasm, localization of orgasm, satisfaction with sexual life, and dyspareunia. None of these sexual variables changed significantly from entry to the 1-year follow-up, apart from dyspareunia, which was significantly (p = 0.009) reduced in both intervention groups. Significant (p < 0.05) predictors for satisfaction with sexual life after hysterectomy were the preoperative satisfaction with sexual life [odds ratio (OR) 32, 95% confidence interval (CI) 10–125], good relationship with partner (OR 50, 95% CI 9–354), physical well-being (OR 0.30, 95% CI 0.09–0.88) and hormone replacement therapy (OR 0.23, 95% CI 0.06–0.78).
Conclusions. Both TAH and SAH significantly reduce dyspareunia without having a negative effect on sexual function. The shift toward SAH seems unwarranted.